Oh, In-Jae; Kim, Kyu-Sik; Kim, Young-Chul; Ban, Hee-Jung; Kwon, Yong-Soo; Kim, Yu-Il; Lim, Sung-Chul; Chung, Woong-Ki; Nam, Taek-Keun; Song, Joo-Young; Yoon, Mee-Sun; Ahn, Sung-Ja
Cancer chemotherapy and pharmacology
2013Dec ; 72 ( 6 ) :1247-54.
PMID : 24091849
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Oh, In-Jae -
Kim, Kyu-Sik -
Kim, Young-Chul -
Ban, Hee-Jung -
Kwon, Yong-Soo -
Kim, Yu-Il -
Lim, Sung-Chul -
Chung, Woong-Ki -
Nam, Taek-Keun -
Song, Joo-Young -
Yoon, Mee-Sun -
Ahn, Sung-Ja -
ABSTRACT
PURPOSE: Concurrent chemoradiotherapy (CCRT) is recommended for the management of patients with unresectable non-small cell lung cancer (NSCLC). This prospective study aimed to compare the efficacy of concurrently delivered cisplatin doublets with paclitaxel, or docetaxel, or gemcitabine.
METHODS: The main eligibility criteria consisted of previously untreated stage IIIB NSCLC. The subjects were randomized into three arms: paclitaxel 45 mg/m(2)/week (TP), docetaxel 20 mg/m(2)/week (DP), and gemcitabine 350 mg/m(2)/week (GP) in addition to cisplatin 20 mg/m(2)/week. Three-dimensional conformal radiotherapy was given once daily, weekly 5 fractions and the total prescription dose was 60-66 Gy. The primary endpoint was response rate, and the secondary endpoints were survival and toxicity.
RESULTS: A total of 101 patients were recruited into this trial of whom 93 (TP: 33, DP: 29, GP: 31) patients were treated with CCRT from March 2005 to July 2007. Similar response rates were observed across arms: TP: 63.6 %, DP: 72.4 %, GP: 61.3 % (p = 0.679). There was no statistically significant difference of median survival (TP: 27.3, DP: 27.6, GP: 16.5 months, p = 0.771). In subgroup analysis, a survival benefit of consolidation chemotherapy was not seen, but leucopenia (63.2 %) and neutropenia (68.4 %) more than grade 3 were significantly high in DP arm. The grade ?? radiation esophagitis was more frequent in the GP arm (22.6 %, p = 0.163).
CONCLUSIONS: Among the three arms, no statistically significant difference in response rate, survival, and toxicity was observed. However, clinically significant radiation toxicity was more frequent in the GP arm.
Non-small cell lung cancer Concurrent chemoradiotherapy Paclitaxel Docetaxel Gemcitabine
MESH
Adult, Aged, Antineoplastic Combined Chemotherapy Protocols/administration & dosage/adverse, Carcinoma, Non-Small-Cell Lung/pathology/*therapy, Chemoradiotherapy/adverse effects/*methods, Cisplatin/administration & dosage, Deoxycytidine/administration & dosage/analogs & derivatives, Female, Humans, Lung Neoplasms/pathology/*therapy, Male, Middle Aged, Neoplasm Staging, Paclitaxel/administration & dosage, Prospective Studies, Radiation Injuries/epidemiology, Radiotherapy, Conformal/adverse effects/methods, Survival Rate, Taxoids/administration & dosage, Treatment Outcome
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